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Biomedical subjects

D M Quinlan

Publications and source records attributed to D M Quinlan.

At least 55 records · Page 3Linked to original sources
PubMed1990

The Levels of Emotional Awareness Scale: a cognitive-developmental measure of emotion.

The Levels of Emotional Awareness Scale (LEAS) is based on a new cognitive-developmental model of emotional experience. The scale poses evocative interpersonal situations and elicits descriptions of the emotional responses of self and others which are scored using specific structural criteria. Forty undergraduates (20 of each sex) were tested. Interrater reliability and intratest homogeneity of the LEAS were strong. The LEAS was significantly correlated with two measures of maturity: the Washington University Sentence Completion Test (SCT) of Ego Development, and the Parental Descriptions Scale-a cognitive-developmental measure of object representation. In addition, the LEAS correlated positively with openness to experience and emotional range but not with measures of specific emotions, repression or the number of words used in the LEAS responses. These findings suggest that it is the level of emotion, not the specific quality of emotion, that is tapped by the LEAS.

Adult↗
PubMed1990

Blunt renal trauma in childhood. Features indicating severe injury.

The clinical presentation of children with blunt renal trauma may differ from that of adults. The clinical features at presentation of 50 consecutive children (20 severe injuries, no pedicle injuries) admitted over a period of almost 8 years were reviewed to determine if there were clinical clues to major renal trauma in childhood. Gross haematuria and low haematocrit were the most helpful factors at the time of presentation and correlated well with severe renal injury. Hypotension was seen in 4 patients and only 1 had severe renal trauma. Suspicion of a major renal injury should be high when there is gross haematuria or a low haematocrit. In this study only 1 of 20 patients with major renal injury demonstrated clinical signs of shock. Unlike adults, hypotension does not appear to be a reliable indicator of the severity of renal injury in children and diagnostic evaluation should not be reserved only for those in shock.

Adolescent↗
PubMed1990

Radical retropubic prostatectomy. Improved anastomosis and urinary continence.

The striated urethral sphincter is the predominant muscular structure divided posteriorly during the apical dissection in radical prostatectomy. The authors have long realized the value of this maneuver in obtaining excellent apical surgical margins and in identifying the correct plane on the anterior surface of the rectum. Recently, they also have recognized the importance of incorporating this musculature into the vesicourethral anastomosis to fix the bladder neck and thus re-establish anatomic continuity. Identification of the striated urethral sphincter ranks in importance with elucidation of the anatomy of the dorsal vein complex and the anatomic identification of the neurovascular bundle in improving the patient's quality of life postoperatively.

Anastomosis, Surgical↗
PubMed1989

The rat as a model for the study of penile erection.

A model has been developed for the study of penile erection in the Sprague-Dawley rat. Anatomical dissections demonstrate a bilateral ganglion lateral to the prostate called the major pelvic ganglion. This ganglion receives input from the pelvic and hypogastric nerves and innervates the pelvic viscera. A large fiber from the major pelvic ganglion courses along the urethra and innervates the corpus cavernosum, the cavernous nerve. In 40 animals, electrical stimulation of either the cavernous nerve or the pelvic nerve resulted in reproducible repetitive tumescence of the corpora cavernosum. Following ablation of the cavernous nerve, electrical stimulation failed to produce erections. Standard mating behavior tests of mounting, intromission and ejaculation in 38 rats showed that surgical ablation of the cavernous nerve resulted in a decrease in the rate of intromissions and ejaculations compared with sham operated controls. Present models for the study of erection have been limited to the dog, monkey and cat. The rat model presented here offers several advantages over these existing models: 1) the cavernous nerve is easily identified, 2) electrical stimulation is easily accomplished and reproducible, 3) behavioral and neurophysiological studies are possible, and 4) animal purchase, housing, and maintenance costs are low. These advantages make this model a uniquely useful tool in the further study of penile erection.

Animals↗
PubMed1989

CT of severe renal trauma in children: evaluation and course of healing with conservative therapy.

Over a 2-year period, blunt renal injuries were classified on a four-point scale: grade 1, contusions; grade 2, tears limited to the cortex (renal lacerations); grade 3, tears extending to the collecting system (renal fractures); and grade 4, renal vascular pedicle injuries. We report our findings in nine children with grade 2 and grade 3 blunt renal injuries who were evaluated with CT. One patient had a nephrectomy; the other eight were managed nonsurgically. Six patients had follow-up CT scans 5-19 months later to assess healing. Scars were evident in each case, and the extent of deformity paralleled the magnitude of the initial injury. One patient with a grade 2 injury and two patients with grade 3 injuries healed with small focal scars; three patients with grade 3 injuries healed with large polar scars. In five patients, the CT findings were compared with the findings on 99mTc-DTPA renal imaging. The injured kidneys contributed 30-45% (mean, 38%) of total renal function. In six patients with renal trauma who were treated conservatively, the involved kidneys healed and significant kidney function was preserved, although early surgical intervention might have been beneficial for one of these patients. Prospective studies are needed to evaluate further the effectiveness of this conservative approach.

Child↗
PubMed1988

Abdominal wall defects and cryptorchidism: an animal model.

Intra-abdominal pressure has been implicated in the mechanism of testicular descent. Boys born with abdominal wall defects reportedly have an increased incidence of cryptorchidism. To examine this relationship further a rat model was developed. The rat testis normally descends postnatally on or about day 21. In this study newborn male rats underwent surgical excision of all anterior abdominal musculature from the umbilicus to the xiphoid, while a control group had a sham procedure. In both groups steel wire was inserted into both testes as radiological markers to monitor descent. Animals were explored on day 28 to confirm the position of the testes. A total of 36 animals survived all sections of the protocol. Eight animals had adhesions and were dropped from the study. The results of 17 rats in the experimental group and 11 in the control group revealed that the surgically created abdominal wall defect did not result in cryptorchidism. This finding suggests that an intact anterior abdominal wall is not a prerequisite for testicular descent in the rat.

Abdominal Muscles↗
PubMed1986

Psychosocial benefits of a cancer support group.

Many clinicians use group support to reduce the psychosocial difficulties of persons with cancer. This study compared the long-term benefits of a thematic counseling model used both as a structure for group support and for counseling patients individually. The thematic model included eight counseling sessions focused on information about cancer and positive health strategies such as progressive relaxation, diet, and exercise. The psychosocial status of women newly diagnosed with gynecologic cancer was assessed before the counseling, immediately after counseling, and again 6 months later. The women who participated in thematic counseling were significantly less depressed and less anxious and had more knowledge of their illness, better relationships with care givers, fewer sexual difficulties, and more participation in leisure activities. Data confirmed the model to be equally helpful whether it was used as a structure for individual counseling or more cost-effective group counseling. This model is easily adaptable to the needs of persons with other forms of cancer.

Adolescent↗
PubMed1985

Skin conductance changes and psychotherapeutic content in the treatment of a phobic patient.

This study examined the relationship between skin conductance response (SCR) and psychotherapeutic content in a single case study. Four SCR conditions of one minute's duration each, reflecting maximal increase (amplitude) and least amount of change as well as one-minute periods preceding these criterion conditions, were measured for each psychotherapy session across 12 consecutive sessions. Psychotherapeutic content corresponding to these SCR conditions was evaluated according to 14 categories by five judges. There were significant relationships between SCR conditions and four psychotherapeutic content categories. Increases in SCR corresponded to a decreasing sense of mastery, increased symptom experience, increased symptom occurrence, and increased negative affects. This study suggests that there was a relationship between a responsive physiological measure and relevant psychotherapeutic content categories in an individual patient.

Adult↗
PubMed1985

Ego development and intelligence in a psychiatric population: Wechsler subtest scores.

The relationship between Loevinger's measure of ego development and the Wechsler Intelligence Scales subtest scores was investigated in 91 adolescent and young adult psychiatric inpatients. Correlations with Verbal IQ and verbal subtests in general were positive and significant. The correlation with the Comprehension subtest was the highest and remained significant when Full Scale IQ was partialled. Post-conformists obtained the highest mean scores on Picture Arrangement; however, there was no difference among the lower stages on this subtest. The results lend support to a social reasoning component of ego development.

Adolescent↗
PubMed1984

Subjective complaints during desipramine treatment. Relative importance of plasma drug concentrations and the severity of depression.

Subjective complaints, including those traditionally considered tricyclic antidepressant side effects, were studied in 43 depressed inpatients during a three-week trial of desipramine hydrochloride. Multiple regression analysis was employed to examine the independent relationship of pretreatment symptoms, concurrent depression, and plasma drug concentrations to subjective complaints reported during treatment. As a group, subjective complaints were positively associated with pretreatment symptoms and the concurrent severity of depression, but not with plasma desipramine concentration. Of the 23 individual complaints studied, three increased during treatment and nine improved. Only two complaints, tremors and light-headedness, were significantly associated with plasma drug concentration. The data indicate that during initial treatment of severe depression with desipramine, subjective complaints are more likely to be symptoms of depression than side effects of the drug and that plasma desipramine determinations would not be useful for predicting or avoiding these complaints. The best management of most symptoms studied was adequate treatment of the depression.

Attitude to Health↗
PubMed1984

Drug-responsive symptoms in melancholia.

Depressive symptoms present in 43 patients with unipolar nondelusional melancholia were studied to determine which symptoms were the best measures of response to desipramine hydrochloride. An extended Hamilton Depression Scale was used to identify symptoms that were present frequently. We then determined which symptoms improved in direct relation to achievement of therapeutic plasma desipramine concentrations, using multiple regression analysis to account for pretreatment symptom severity. In ten symptoms, improvement was significantly associated with desipramine treatment. These ten symptoms seem to be the best measure of drug response during tricyclic antidepressant treatment in patients with nondelusional melancholia.

Delusions↗
PubMed1984

Family history in delusional depression.

Family psychiatric history was compared in the 472 first-degree relatives of 31 delusional and 35 nondelusional inpatients who met DSM III criteria for major depression with melancholia. Morbid risks for psychiatric illness or for psychiatric treatment variables did not differ between the two groups. Specifically, rates of affective and psychotic illnesses in families did not distinguish delusional from nondelusional probands. The findings do not support the hypothesis of a genetic relationship of nonaffective psychosis to delusional depression.

Adult↗
PubMed1984

The clinical utility of family history for the diagnosis of melancholia.

History of psychiatric illness in 982 first degree relatives of 155 inpatients with major depression was examined to determine its clinical value for distinguishing melancholic from nonmelancholic major depressions. A positive family history of unipolar depression was not more common in the melancholic patients, although relatives of melancholic probands were more likely to have received electroconvulsive therapy or experienced nonaffective psychosis. Whereas the morbid risk estimate for unipolar depression was higher in the relatives of nonmelancholic probands, this appeared to be related to the manner in which morbid risk was calculated. Two methodological problems, variability in the risk periods of depressive subtypes, and the reliability of subtyping depressed family members, are discussed with respect to their implications for future family studies.

Adult↗
PubMed1983

Psychosocial reactions to the diagnosis of gynecologic cancer.

Data are presented on the psychosocial impact of gynecologic cancer derived from both a structured interview and self-report scales administered to 60 women newly diagnosed with cervical, uterine, and ovarian malignancies. Findings show that such women experience mild to moderate symptoms of depression and anxiety, as well as impairment of vocational, domestic, and sexual functioning. The women with cancer reported significantly fewer symptoms of depression and social impairment than acutely depressed women without cancer. The women studied also demonstrated significantly more symptoms of depression and social impairment than women without psychiatric disease from randomly selected community samples. The symptoms of depression experienced by women with ovarian cancer, women receiving triple-agent chemotherapy and women with poorly differentiated tumors of the endometrium and ovary approached the level of acute symptoms typically reported by women entering outpatient psychiatric clinics. These observations should enhance the understanding of these problems among gynecologists and other health care providers in offering appropriate psychosocial support for women with gynecologic cancer.

Adolescent↗
PubMed1982

Major adverse reactions during desipramine treatment: relationship to plasma drug concentrations, concomitant antipsychotic treatment, and patient characteristics.

Major adverse reactions interrupting drug therapy during treatment of 84 patients with desipramine hydrochloride were studied to determine their relationship to desipramine plasma concentrations and other clinical variables. The frequency of adverse reactions was higher in patients over 60 years old (39%), and in patients also receiving antipsychotic medications (32%), but low in patients under 60 years old (7%). Desipramine plasma concentrations in patients having side effects did not differ significantly from those in patients without side effects. Steady state desipramine plasma concentrations did not increase with age. Symptomatic orthostatic hypotension, the most common side effect encountered, occurred early in treatment at low desipramine plasma concentrations. Other side effects, usually described as anticholinergic, occurred exclusively in the 34 patients receiving both desipramine and antipsychotic drugs. The concentration of 2-hydroxy-desipramine, the total concentration of 2-hydroxy-desipramine and desipramine, and the ratio of 2-hydroxy-desipramine to desipramine were not higher in 11 patients having side effects than in a comparison group without side effects.

Adult↗
PubMed1982

Desipramine plasma concentration and antidepressant response.

The relationship of desipramine hydrochloride plasma concentration and antidepressant response was determined in 30 depressed inpatients treated for three weeks with desipramine. All patients had a nondelusional unipolar depression, met DSM-III criteria for major depressive episode with melancholia, and had a Hamilton score of 18 or greater after one week of hospitalization without medication. Eighty-nine percent of the patients with plasma concentrations above 115 ng/mL responded, in contrast to 14% of those with concentrations below this level, a significant difference (Fisher's exact test, P less than .001). Ten initial nonresponders were converted to responders when dosage increase raised desipramine plasma concentration to 125 ng/mL or above. In clinical practice a plasma concentration of 125 ng/mL would be a useful guideline as a threshold above which desipramine is likely to be effective.

Depressive Disorder↗